GeneWatch: While you were researching and filming Eggsploitation, what sense did you get of why women decide to donate their eggs in the first place? You looked primarily at North America; is it different in other parts of the world?

Jennifer Lahl: If you look at what's happening in Eastern European countries, it is largely poor women who are selling their eggs because they need money. If you look at the women who donate eggs in the United States, they are often doing it to make money, but by world standards they are by no means poor. In some countries women are selling their eggs because they are trying to pay rent and put food on their table, whereas here in the United States it's more likely to be the college age student who has a lot of student loan debt and is looking at an unfavorable economy and job market. Although both are motivated by financial need, I would never want to say that the plight of those women is the same. "Poor" is certainly a relative term.

In the U.S., most egg donors are women in their early to mid-twenties. They tend to be educated young women, recruited on university campuses by ads asking for someone who is tall and pretty and smart.

GW: And the specifics of those ads reflect the demands of the people on the other end, right, the "consumer" of the eggs?

JL: Yes, they are the ones who dictate the genetic profile of the donor. They want someone who is healthy, that's going to fit into the family photos. You're not going to typically see, say, an African American couple asking for an Asian woman's eggs.

GW: What have you learned about why people get into egg donation from the consumer side, as opposed to other options such as surrogacy?

JL: They often call them the "commissioning parents," usually an infertile couple-although that's not the case if it's a single woman using the technologies by choice or a same-sex couple-but they typically are a man and a woman who are tired of dealing with issues of infertility. They do not necessarily want to use a surrogate due to the financial burden, and a lot of women want the experience of being pregnant, giving birth and nursing a baby, which is not available if you use a surrogate; so they are trying to use technology as best they can to mirror a natural pregnancy.

GW: Are there forms of egg donation being done that you find acceptable?

JL: I don't see that to be the case. Look in other countries: commercial surrogacy is prohibited in Canada, the selling of human gametes is prohibited in France. In a perfect world, we would have done a whole lot of research before allowing these procedures. That's something we uncovered in Eggsploitation: we've never done any long-term studies on the risks of these drugs and procedures on otherwise healthy young women. Is there a negative long-term impact on their own fertility? Is there a link to certain types of cancers because of taking the drug? I'm also concerned about the environmental risk, with all of these hormones making their way into our waters and our soils and our living environments.

So how do you mitigate all of those and say, "If we could control all of those things, then I could endorse egg donation." But I don't see how we could control all of those variables. There are just too many cautionary flags for me to believe that we would be able to mitigate them.

GW: Would it make a difference if it wasn't a commercial transaction-if no one was being paid to donate eggs, but only doing it voluntarily? Obviously there would be less of it ...

JL: So they say, but they haven't seen a decline in sperm donation in the United Kingdom after they took the money out of it. Now, it might be different with egg donation, since it's a more onerous procedure-sperm donation can take five minutes, whereas egg donation can take several weeks. Certainly what we see in Canada is that taking the money out of it encourages more young women to fly to the United States. For example, I remember speaking to one egg broker who said at any given moment half of the donors in her database were willing to come down from Canada. Even the ASRM (American Society of Reproductive Medicine) guidelines list travel as one of the acceptable reasons for driving up the cost for commissioning parents. If you have an egg donor in California and a couple in New York, the couple has to be willing to pay more because they have to fly the egg donor across the country. That's recognized by the ASRM as a justified piece of the compensation formula.

A lot of this industry is driven by reproductive tourism. You can freeze embryos, you can freeze sperm, you can freeze eggs, and you can fly people and all the different parts all over the world to put together a baby.

GW: In the U.S., who is it that you see, politically, coming out and showing concern about egg donation and opposing it?

JL: I think this is where the U.S. is strangely strapped to abortion politics. This is why I point to Canada: it's not such a religious nation, I don't believe, but their laws are very restrictive here. They outlaw all forms of human cloning in Canada, not because of religion.

Here in the U.S., the media and the shareholders in the IVF industry want to make it a partisan issue-which I think is very unfortunate, because it's not.

I work very closely with Kathy Sloan, Diane Beeson and Tina Stevens, and they might consider me a person on the right because I'm concerned about the commodification of life; but I consider this a big tent issue. I don't know why anybody would be content with laws that don't protect a twenty-something year-old woman on a college campus who is being offered large sums of money to do something she is told is safe, when in fact it isn't safe, and there are short and long term lasting implications.

GW: You mentioned the media trying to make this a partisan issue. How does that rendition tend to play out?

JL: There's an idea that things have to fit a narrative. It's really hard to break out of a strong narrative, and we have a strong narrative in the United States that says "if you believe x, y and z you're liberal, and if you believe a, b and c then you're conservative." These are issues that require a lot of thinking. Most media interviews I do, people are on deadline, they have so many words they need to crank out in a short period of time, so they try to get somebody on either side on an issue so they get an opposing view. We're in a sound bite culture, and it's just so easy to swim in the same direction of the stream we've always done. But these emerging technologies really require us to think about what is happening now, which we're going to have to live with for decades.

I don't want to bash the media; this is just an observation of what it is. It's easier to go with the same left-versus-right narrative; if you're on the left you have to be with this person, and if you're on the right you have to be with that person.

It's unfortunate, because I sit and talk to all kinds of people, and when they hear or watch Eggsploitation-I show it to a mixed audience, all over-people are just aghast. They can't believe this is actually happening, and they want it stopped. When I go to Capitol Hill, people ask "Who's behind you? Who's supporting you? Well, if you get this person, maybe I'll join you." It's very political; people want cover. So when you have people from different sides on other issues saying they are in agreement when it comes to egg donations, it's really refreshing.

GW: There are also people who support the existence of and oppose regulation of the egg donation industry. What sort of opposition have you come up against?

JL: Our most vocal opponents are the people in the industry: the fertility doctors, the brokers that are running the clinic, or the lawyers that are representing them; people who have a vested interest in the technology. They want to downplay what has happened to the women appearing in Eggsploitation as unfortunate and, while very tragic, still uncommon. And I would say back to them: The burden is on you to prove that. Since you've never done any meaningful long-term studies, you're just blowing smoke by saying that what happened to these women is an insignificant portion of the patient population.

Some people who have used the technology also oppose us. Not all of them-I just got an email from a woman in Australia who used an egg donor to have a child and who has since become very critical of what she did and of the industry-but still, there are a lot of women (and probably men, too, but I hear mostly from women) who have used the technology to create a child and are very critical of what we're doing, whether they feel judged or condemned, or whether they feel that the work that I'm trying to do is going to negatively impact other women who want to use egg donation or surrogacy to have a child.

GW: In Eggsploitation-and since then, I'm sure-you have spoken to many women who suffered serious health complications as a result of donating eggs. Has anyone gotten into trouble as a result of this, and do the women have any recourse to do anything about it when they suffer short or long-term complications?

JL: The tagline of the film is "The infertility industry has a dirty little secret." One of the things that I've not really been able to put my finger on, but is an element of the 'eggsploitation,' is that a lot of the egg donors here in the United States make the decision kind of privately; then, later, they really regret what they've done. They start thinking, "How could I have been so desperate for what now seems like such a tiny sum of money, given that I almost died?" Two of the women in the film were told that what happened to them was their own fault, and it's really hard for them-my words, again, not theirs-it's hard for them to advocate against an industry that is, when they look at it, the medical establishment. These are the experts; so when they have been told that what happened to them was their own fault, and certainly no fault of the industry, they feel a sense of shame. A lot of them didn't call their mom up and say "Guess what I'm doing next weekend? I'm selling my eggs!"

One of the women in the film actually did file a lawsuit which was settled out of court for an undisclosed amount. One woman didn't think she could sue, and now she thinks it's past the statute of limitations. Again, these are really smart but still young women, being faced with monumental incidents in their life. They sign all these legal agreements, and they are told beforehand that they have a lawyer, but the lawyer represents the industry. For two of the women who ended up with enormous hospital bills, their own private insurance had to pick up the tab, because they had better insurance than the industry provides an egg donor. They are told in the beginning that they have insurance, that the company has a policy for them if anything goes wrong, but it's not comprehensive enough to take on the enormity of the medical expenses that have occurred.

Part of me thinks, gosh, if we could just let the insurance company know how many of their dollars are being wasted on otherwise healthy women who are undertaking these surgery procedures for no other reason than to help somebody ... they might say, wait a minute, we're not covering this anymore! All of the women in the film who are living still have ongoing medical debt. They are cancer survivors, or they are undergoing their own infertility workups since they now can't have children of their own. One is in a high-risk pregnancy right now. She had to have so much blood transfusion when she initially sold her eggs and was bleeding out that now she has developed an Rh incompatibility with the baby she is carrying.

The U.S. government recently prohibited credit card companies from advertising on university campuses, because there was such a concern that young people would get credit cards and graduate with enormous debt. You'll hear again and again: "These are smart girls, they should be able to make these decisions for themselves, and if they want to do this with their body they should be allowed to do it." And I say: Why can't they have credit cards, then? Why are we concerned about their financial well being? Shouldn't we be more concerned about these women graduating without dying and having their fertility intact?

GW: Would you like to see egg donation banned entirely in the U.S.?

JL: No... I advocate for taking the money out of it. That would be a first step: you can donate but you can't pay for eggs. I would like to see the anonymity taken out of it, which has just happened in Canada under a Supreme Court decision that you must make the biological information of donors available to offspring so that the children have access to that information. And I think in the instance of egg donation-using egg donors, not women who are using their own eggs-that we need a moratorium so that we can begin collecting the data and doing the studies. Informed consent right now is meaningless. And you can't give informed consent with money. I worked as a nurse for 25 years; I had thousands of people sign informed consent documents, and there's never money entangled in informed consent.

So take the money out of it, take the anonymity out of it; and as it relates to young, healthy women being used to donate eggs, we need a moratorium. We can go back, we can collect retrospective data, we can start doing studies with the data we already have, and start making a better case for whether this is safe or not, what the risks are and how significant they are in the short and long term. Let's comb through the breast cancer registry. How many of those women used infertility drugs? How many were egg donors? Comb through the hospital records: How many times was a woman admitted for ovarian hyperstimulation syndrome? We need to start looking at the data that we have in some organized way, and it will probably have to be compelled by the government. The industry isn't going to do it on their own.

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